The 3 on 6™ has been around for over a decade now with thousands of procedures performed. Sufficient data has been collected so that we can predict and prevent most complications before they happen. Complications can certainly happen, but many of the critiques that have been lobbed by skeptics are uninformed and untrue.
For the patients that do experience complications, lack of proper care and maintenance of the implants and bridges is the most common factor associated with problems after treatment. In this article, we will address some of the misconceptions that people have about the 3 on 6.
Misconception 1 - The bridges will break
In the past, bridges were more susceptible to breaking because of the quality of the materials used and improper fit. Around 20 years ago, zirconia started being used in dental crowns and bridges and has become a preferred material to replace teeth because of its beauty and strength.
The 3 on 6 is a full arch of teeth, segmented into three separate bridges with four teeth on each bridge. These bridges are made of zirconia, a material that is stronger than natural teeth and is not susceptible to decay. As opposed to an All-on-X device which spans the entire arch of the mouth, each 3 on 6 bridge consists of four teeth (4-unit bridge) and are roughly one inch long. Research and common sense demonstrate that the shorter the length of a bridge, the harder it is to break, much like a pencil.
At your consultation, you can handle a zirconia bridge to see if you can break it. Spoiler alert: you won’t be able to! In the rare occasion that a bridge does break due to a traumatic event such as a sports injury or car accident, the good news is that a 4-unit bridge isn’t as expensive to replace as a full arch prosthetic. In summary, smaller bridges are less likely to break, and less expensive to replace.
Finally, due to our digital scanning technology, combined with photogrammetry, the fit of our bridges in your mouth will be accurate to hundredths of a millimeter. When you bite, the forces will be evenly distributed across the bridge, which also decreases the likelihood of a break.
Misconception 2 - The gums will have a gap
A field of grass is supported by healthy soil, and beautiful gum tissue is supported by healthy bone. Since the 3 on 6 bridges sit directly against your natural gums, the bone needs to be healthy so no gap is created in between the gums and the teeth. For this reason it is important to develop good oral hygiene habits and attend regular dental cleanings and checkups.
Our bodies are amazing and when treated properly they can produce incredible results. We have patients returning for cleanings who have had their 3 on 6 smiles for five, eight, even ten years! For almost every one of these patients, the gums between the bridges and each tooth still look natural and healthy. Additionally, many of our patients' gums have created a connection to their zirconia bridges, eliminating the need to floss underneath the bridges.
Bone is similar to muscle in that it needs stimulation to maintain its strength and density. Our experience has shown that patients who properly care for their teeth and health can experience bone growth around their implant sites, and an increase in their tissue thickness. Many of our patients weren’t eating and chewing harder things prior to their 3 on 6 procedure. Beginning to eat again and creating pressure against the jawbone can help stimulate growth in the area.
Misconception 3 - One full arch is better than 3 segmented bridges
There is a concept in dentistry called splinting, where a single bridge is placed across all the implants in an arch. This creates an effect called “cross-arch stabilization” which means that pressures in the mouth are evenly distributed across the entire mouth. This is done to prevent the implants from moving while they osseointegrate, or heal to the bone, which can cause implant failure.
Cross-arch stabilization is a method utilized in the 3 on 6 procedure during the healing phase with a set of temporary teeth, placed at the time of surgery. Once the implants have healed to the bone, the single bridge is replaced with three separate bridges. As mentioned above, this decreases the likelihood of the bridges breaking. Another crucial benefit of segmented bridges is that this increases the stimulation forces that each implant receives, leading to healthy bone growth in the jaw.
Just like any bone or muscle in the body, a splint can be utilized to help during healing, but once healed, the splint should be removed. Unfortunately, many patients are unaware that an All-on-X style restoration is splinting their jawbone, reducing the implant stimulation, and contributing to bone loss. This phenomenon is one of the main reasons why gaps commonly form in All-on-4 or All-on-X cases, and why 3 on 6 patients have had such great long-term results.
Misconception 4 - Very few people qualify for 3 on 6
We mostly hear this misconception from people who have seen a dentist that hasn’t been trained in this type of procedure. The 3 on 6 is relatively new, and most dentists don’t know when 3 on 6 would be appropriate versus another procedure such as All-on-4. Often, their concern is that a patient doesn’t have enough bone for this type of procedure.
It’s true that a certain level of bone is required for the 3 on 6. Most 3 on 6 providers offer free consultations with a scan to see if your bone level would qualify. Over 90% of the people we do consultations with have enough bone to qualify for the 3 on 6. Many of these people were told by a dentist they didn’t have enough bone for this type of treatment. The good news is that if you don’t have enough bone to qualify, all 3 on 6 providers are also trained in providing an All-on-X. The 3 on 6 is a more time-consuming procedure for your dentist than the All-on-X, so you can rest assured that if your dentist recommends the 3 on 6, you are a candidate.
Conclusion
If you have questions about the 3 on 6 procedure, or have heard things that concern you, the best thing to do is schedule a consultation with a licensed 3 on 6 provider and have your questions answered directly. The 3 on 6 may not be the appropriate solution for your situation, but only a doctor that has experience providing the 3 on 6 would be able to make that judgment. If the 3 on 6 isn’t the appropriate solution, a 3 on 6 provider can offer other appropriate options.